Today's News and Commentary

About pharma

Medical Marketing in the United States, 1997-2016: This article is a nice review about how much medical marketing has grown in the US, despite restrictions on direct physician marketing practices. According to the research:
”From 1997 through 2016, spending on medical marketing of drugs, disease awareness campaigns, health services, and laboratory testing increased from $17.7 to $29.9 billion. The most rapid increase was in direct-to-consumer (DTC) advertising, which increased from $2.1 billion (11.9%) of total spending in 1997 to $9.6 billion (32.0%) of total spending in 2016. DTC prescription drug advertising increased from $1.3 billion (79 000 ads) to $6 billion (4.6 million ads [including 663 000 TV commercials]), with a shift toward advertising high-cost biologics and cancer immunotherapies.” Sadly, one of the authors, Dr. Lisa Schwartz recently died.

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If you cannot access the original, read the Kaiser Health News comments

Drugmaker Eli Lilly to start publishing list prices of drugs: In October, members of the trade group PhRMA agreed to post prices for advertised drugs. But the prices are so different among pharmacies and insurance plans that it would be impossible to give the information in a short commercial message. (Recall that side effects must also be given.) So companies are going to give website addresses and toll-free numbers where patients can get an idea of what the medication might cost. Lilly has touted itself as the first company to comply with this industry guideline by making prices about its diabetes treatment Trulicity available.

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Prescription Drug Costs Driven By Manufacturer Price Hikes, Not Innovation: Recall that expenses are driven by price, volume and intensity (in this case, innovation). The study quoted in this article from Health Affairs(Subscription required) concluded that: “The rising costs of generic and specialty drugs were mostly driven by new product entry, whereas the rising costs of brand-name drugs were due to existing drug price inflation.” It should be noted that drug costs will be higher if enough people who should be taking medication were doing so- particularly for diabetes and high blood pressure.

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New California governor tackles drug prices in first act: New California Governor Gavin Newsom has already started to shake up the healthcare landscape. He announced that instead of using managed care models, the state would act as purchaser for all 13 million Medicaid recipients. Additionally, his executive order creates a mechanism allowing “private companies and other governmental agencies to participate in the process of negotiating drug prices with pharmaceutical companies.” The entity would be the biggest single purchaser of pharmaceuticals in the US. (Read below about what is happening with insurance in California.)

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About information technology

Rush working with AT&T to be the first 5G-enabled U.S. hospital: The latest push in technology is implementation of 5G-enabled equipment that will greatly increase speeds of transmission. This technology can help in the healthcare field by, among other activities, enhancing telemedicine and device communication capabilities. The joint venture should be carefully followed to assess the future of this advance on healthcare delivery.

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About the public’s health

Facts & Figures 2019: US Cancer Death Rate has Dropped 27% in 25 Years: Now some good news. The reasons for this drop are not only increases in early detection and treatment, but reductions in smoking. But like many other health statistics, the results show benefits are uneven in the population.

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Prevalence of and Factors Associated With Patient Nondisclosure of Medically Relevant Information to Clinicians: Technology and delivery systems will not help healthcare if patients lack trust. This article looks at what patients withhold and why. “ …most participants reported withholding at least 1 of 7 types of medically relevant information, especially when they disagreed with the clinician’s recommendations or misunderstood the clinician’s instructions. The most commonly reported reasons for not disclosing information included not wanting to be judged or hear how harmful their behavior is.” In one of the two studies reviewed in this article those most likely to withhold information were female, younger, or had worse self-rated health. An association was not found for: those who have a chronic illness; with educational level : or with race.

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Read the popular media version

About insurance

Announcements about insurance expansions: As Republicans have tried to dismantle the ACA, Democratic jurisdictions have come up with their own plans to extend benefits to the uninsured. These efforts now include California, Washington State and NY City.

Read the article about NY City
Read the article about California
Read more about the Washington announcement